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一项基于美国食品药品监督管理局不良事件报告系统的关于布罗达单抗的真实世界药物警戒研究。

A real-world Pharmacovigilance study of brodalumab based on the FDA adverse event reporting system.

作者信息

He Ke, Zhao Kaidi, Yin Tingyi, Liu Meng, Liu Jiashu, Du Wenqian, Liu Xinyi, Cheng Baochen, Zhang Dewu, Zheng Yan

机构信息

Department of Dermatology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China.

Department of Dermatology, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China.

出版信息

Sci Rep. 2025 Jan 17;15(1):2346. doi: 10.1038/s41598-025-86976-y.

Abstract

Brodalumab, a humanized monoclonal antibody that targets the interleukin-17 receptor A, is primarily used to manage moderate-to-severe plaque psoriasis. Although it has demonstrated favorable efficacy and safety in clinical trials, the strict inclusion and exclusion criteria may not fully reflect its safety profile in real-world settings. As its use becomes more widespread in clinical practice, understanding its safety in real-world applications is crucial.This study employed disproportionality analysis to assess the safety of brodalumab by examining all adverse event reports that identified brodalumab as the primary suspected drug in the FDA Adverse Event Reporting System database since 2017. Techniques such as the Reporting Odds Ratio, Proportional Reporting Ratio, Multi-item Gamma Poisson Shrinker, and Bayesian Confidence Propagation Neural Network were utilized to analyze the adverse events associated with brodalumab. Additionally, the Weibull distribution was used to model the temporal risk of adverse events.The study identified several adverse reactions already listed on the drug's label that showed positive signals, including arthralgia, headache, myalgia, suicidal ideation, oropharyngeal pain, injection site mass, and infections. Additionally, we found potential adverse reactions not noted on the drug's label that exhibited positive signals, including depression, increased blood pressure, peripheral swelling, gait disturbance, inability to walk, stress, myocardial infarction, sepsis, uveitis, nephrolithiasis, and interstitial lung disease. Moreover, this analysis highlighted the critical need for vigilant monitoring of adverse events, especially during the first month following the initiation of treatment.This study provides initial insights into the real-world safety of brodalumab, confirming known adverse reactions and uncovering additional potential risks. The results deliver vital information that can assist clinicians in making informed decisions when prescribing brodalumab for psoriasis treatment.

摘要

布罗达单抗是一种靶向白细胞介素-17受体A的人源化单克隆抗体,主要用于治疗中重度斑块状银屑病。尽管它在临床试验中已显示出良好的疗效和安全性,但严格的纳入和排除标准可能无法完全反映其在现实环境中的安全性。随着其在临床实践中的应用越来越广泛,了解其在实际应用中的安全性至关重要。本研究采用不成比例分析方法,通过检查自2017年以来在美国食品药品监督管理局不良事件报告系统数据库中所有将布罗达单抗确定为主要怀疑药物的不良事件报告,来评估布罗达单抗的安全性。采用报告比值比、比例报告比、多项伽马泊松收缩器和贝叶斯置信传播神经网络等技术分析与布罗达单抗相关的不良事件。此外,使用威布尔分布对不良事件的时间风险进行建模。该研究确定了药物标签上已列出的几种显示阳性信号的不良反应,包括关节痛、头痛、肌痛、自杀意念、口咽痛、注射部位肿块和感染。此外,我们发现了药物标签上未注明但显示阳性信号的潜在不良反应,包括抑郁、血压升高、外周水肿、步态障碍、无法行走、应激、心肌梗死、脓毒症、葡萄膜炎、肾结石和间质性肺病。此外,该分析强调了对不良事件进行警惕监测的迫切需要,尤其是在治疗开始后的第一个月。本研究为布罗达单抗的实际安全性提供了初步见解,证实了已知的不良反应并发现了其他潜在风险。研究结果提供了重要信息,可帮助临床医生在为银屑病治疗开具布罗达单抗处方时做出明智决策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c12e/11742032/28f02d77a355/41598_2025_86976_Fig1_HTML.jpg

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